Preliminary thoughts on #CassandraC case in Connecticut

via the Hartford Courant. This afternoon the Connecticut Supreme Court ruled that the 17-year old woman identified in court documents as Cassandra C. “is not legally mature enough to decide against life-saving chemotherapy” for Hodgkins lymphoma.

Despite a poor prognosis without chemotherapy, Cassandra refused treatment from the beginning and after she missed several medical appointments last fall her doctors reported her case to the state’s Department of Children and Families (DCF), accusing her mother, Jackie Fortin of Windsor Locks, with medical neglect. The DCF removed Cassandra from her home and placed her in state custody. Cassandra ran away in November after receiving two treatments . After she returned a week later, she was placed in Connecticut Children’s Medical Center where she continued to receive medical treatment. Meanwhile, Cassandra’s mother and lawyers filed an appeal with the state’s highest court. The court documents contend that the right to bodily integrity, “which is so fundamentally a part of the human experience that its recognition and protection stretch back long before any written constitution” applies to minors as well as adults. Cassandra’s lawyers draw on the legal concept of a “mature minor” which allows minors to give consent to medical procedures if they can show that they are mature enough to make a decision on their own.

Since I’ve written a book on the history of adolescent medicine, I’ve been following this case since last September. My university relations office has given my name to the local press, who may or may not be contacting me for an interview. Meanwhile, I’ll post my preliminary thoughts. The mature minor concept was the cornerstone of U.S. Supreme Court decisions involving a minor’s right to consent to health care, including receiving birth control and abortion, without parental approval or knowledge. (see Baird v. Eisenstadt and Bellotti v. Baird).

As much as I disagree with Cassandra’s decision to refuse treatment, I think the mature minor concept is applicable to this case. Now I’m waiting for the phone to ring. . .